Friday, March 06, 2009

Handicap

I REFER to last Saturday's report, 'New NUH chief's focus: Lack of beds', in which the new CEO of National University Hospital, Mr Joe Sim, was quoted as saying: 'I find it easier not being medically trained. This way I have no baggage when I make decisions as they are non-biased and this is good for the hospital and the system.'

These words are disconcerting to me as a doctor. Mr Sim implies it is a handicap for a hospital CEO to be medically trained, and medical training would make one biased so decisions made by a doctor-CEO are bad for the hospital and the system.

There are many factors that are important in a good hospital CEO. A medical, nursing or allied health background does confer some advantage at the start because the time required to acquire health-care and hospital domain knowledge is less. I can agree that a hospital CEO does not have to be a doctor. But it is wrong to say that medical training leads to a biased hospital CEO.

What is important is not the CEO's background, but his personal attributes. There are several examples of doctors and non-doctors who have been both bad and good hospital CEOs. One obvious responsibility of any hospital CEO is doctor- engagement. For any hospital to flourish, a CEO must learn to engage doctors, and vice versa, in a honest, friendly and constructive way based on mutual respect and understanding. Labelling doctors as carrying psychological baggage is simply not the best way to start life as a hospital CEO.

Dr Chong Yeh Woei Not having been a CEO of a hospital, angry doc cannot say for sure if being a doctor is an asset or a liability to the execution of one's duties as one. He suspects that, like Dr Chong stated, it is more an issue of one's personal attributes than one's past training.(If one were to pick a CEO based on his or her training, angry doc would venture to suggest that the best person to run a hospital would be a nurse, since the business end of a hospital is actually the bed.)Nevertheless, angry doc suspects that regardless of his or her past training, the job description of a CEO will require one to say things like:"... my key priority for the next three years is to balance patients coming in from the emergency department and elective patients, ... We need a healthy proportion of electives in the face of an increasing emergency load. At the same time, we are under pressure to meet ER (emergency room) care."which makes angry doc cringe more than:"I find it easier not being medically trained. This way, I have no baggage when I make decisions as they are non-biased and this is good for the hospital and the system."angry doc's point, however is not about who should run a hospital, or what a hospital should be run for, or even if Mr Sim will make a good CEO of a hospital - angry doc doesn't know Mr Sim personally, but according to the report the man has been in the healthcare business for about seven years and have been working in the hospital for more than two, so he presumably knows a thing or two about how things work - but about how something one said which at the time of utterance seemed innocuous enough to oneself can be made to make one look rather bad when the wrong emphasis is given by the media.One may believe in certain things, but there are certain things that one simply does not say to the media.That Mr Sim had not known that before he gave the interview is probably the only thing angry doc can fault him on.